epistaxis management cause cure complete pptx

Epistaxis Cause management types of epistaxis how to cure

1. EPISTAXIS Dr. Avneesh Chaudhary

2. BLOOD SUPPLY NASAL SEPTUM

3. Little’s Area

4. EPISTAXIS - DEFINITION Bleeding from inside the nose Seen in all age groups as emergency Sign of local or constitutional cause

5. Sites of epistaxis Little’s area Above the level of middle turbinate Below the level of middle turbinate Posterior part of nasal cavity Diffuse Nasopharynx

6. Classification Anterior Posterior

7. Anterior Epistaxis

8. Posterior epistaxis

9. ANTERIOR More common Little’s area,ant. Part of lat. Nasal wall Children /young adult Trauma Mild Local pressure/ant. pack Less common Post. Superior part-nasal cavity >40yrs Spontaneous; often d/t HTN or arteriosclerosis Hospitalization Post nasal pack POSTERIOR Incidence Site Age Cause Bleeding

10. Causes Local General Idiopathic

11. a.Local 1.Congenital Unilateral choanal atresia Meningocoele Encephalocoele Glioma Glioma

12. 2.Trauma Injuries of nose Intra nasal surgery Violent sneeze Fracture of middle one third of face & base of skull

13. 4.Infection Acute Viral rhinitis Nasal diphtheria A/c sinusitis Chronic Atrophic rhinitis Rhinitis sicca Tuberculosis Syphilis Rhinosporidiosis

14. 4.Foreign bodies Non-living Rhinolith Foreign body Living Maggots,leech

15. 6.Atmospheric changes High altitude Caissons disease 7.DNS

16. nasopharynx Adenoiditis Juvenile angiofibroma Malignant tumors

17. GENERAL CVS Hypertension Arteriosclerosis Mitral stenosis Blood disorder Aplastic anemia Leukemia Hemophilia

18. Liver disease Hepatic cirrhosis Kidney disease C/c nephritis Drugs Salicylates Anti coagulant therapy

19. Mediastinal compression Tumors A/c general infection Influenza Chicken pox Malaria Vicarious menstruation

20. MANAGEMENT

21. Enquire….. Mode of onset Duration & frequency Site Side Type Any medical ailment Drug intake

22. FIRST AID Littles area compression Trotters method

23. CAUTERIZATION IN ANT. EPISTAXIS Anaesthetize bleeding point Cauterise with bead of silver nitrate/coagulate with electro cautery

24. Anterior nasal packing

25. Posterior nasal packing

26. Or…. Foley’s catheter Nasal baloon

27. Endoscopic cautery Better location of posterior bleed Local anaesthesia with sedation It is coagulated with suction cautery Elevation of mucoperiosteal flap& SMR operation

28. Ligation of vessels External carotid – above origin of sup. Thyroid A. Maxillary artery Approach via Caldwell-Luc operation Ethmoidal arteries

29. General Measures Sit up with back rest Record blood loss in spitting & vomiting Reassure Mild sedation Check vital signs Maintain haemodynamics -blood transfusion if required Intermittent oxygenation Investigate & treat

30. Hereditary hemorrhagic telangiectasia Osler-Weber- Rendu disease is a genetic disorder that leads to abnormal blood vessel formation in the skin , mucous membranes It may lead to nosebleeds , acute and chronic digestive tract bleeding , and various problems due to the involvement of other organs.

31. Can occur on anterior part of nasal septum Argon,KTP ( Potassium titanyl phosphate) or Nd;YAG laser ( neodymium-doped yttrium aluminum garnet ) Septodermoploasty

32. ThANK YOu